Concussion in the Emergency Department: A Review of Current Guidelines - Trauma EXTRA Supplement -

Concussion in the Emergency Department: A Review of Current Guidelines - Trauma EXTRA Supplement
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Publication Date: September 2019 (Volume 21, Supplement 9)

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Susan B. Kirelik, MD, FAAP
Medical Director, Rocky Mountain Pediatric OrthoONE Center for Concussion; Attending Pediatric Emergency Physician, Rocky Mountain Hospital for Children, Denver, CO

Peer Reviewers

Jeffrey J. Bazarian, MD, MPH
Professor of Emergency Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY
Tamara R. Espinoza, MD, MPH, FACEP
Co-Chair, Traumatic Brain Injury Task Force, Injury Prevention Research Center at Emory; Assistant Professor, Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA


The United States Centers for Disease Control and Prevention (CDC) estimates the incidence of sports-related mTBI in the United States to be 1.6 to 3.8 million per year, based on extrapolation of data from a 1991 study.1 A more recent study estimates that 1.1 to 1.9 million sports-related concussions occur each year in youth athletes in the United States.2 Concussive injuries account for an increasing number of presentations to the ED in the United States. A 2014 study demonstrated an 8-fold increase in ED visits for TBI when compared to total ED visits between 2006 and 2010. This increase may be due to a combination of factors, including improved screening and diagnostic tools, increased exposure to TBI due to early dedication to competitive sport, and more public awareness of TBI.3

Excerpt From This Issue

The annual number of emergency department (ED) visits for traumatic brain injury (TBI) is rising in the United States, with the majority of these visits resulting in a diagnosis of mild traumatic brain injury (mTBI), or concussion. There are limited data to support objective clinical measures to guide the management of concussion, but several guidelines have been published that provide recommendations for evaluation and management of concussion and mTBI. This supplement provides a summary of 2 recently published, consensus-based guidelines and discusses practical aspects of ED management of patients with concussive injuries, including the initial evaluation, diagnostic criteria, assessment tools, and aftercare recommendations.

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